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Background: Overweight and obesity during adolescence is an important public health problem. However, little is known about the age-and sex-specific mid-upper arm circumference (MUAC) cut-offs for identifying overweight and obese adolescents. Objectives: The present study was planned to assess diagnostic performance of MUAC in identifying overweight and obese adolescents and estimating age specific MUAC cut-offs, separately for males and females, taking body mass index for age Z-score (BAZ) as the gold standard. Methods: The present study is secondary data analysis using Comprehensive National Nutrition Survey, India, on 31,471 adolescents. The, area under curve receiver operating characteristic curve (AUC), and Youden Index were used to estimate MUAC cut-offs for overweight (BAZ > +1) and obesity (BAZ > +2). Results: The MUAC cut-offs to identify overweight were: For 10–14 years– 22.9/23.4 cm, for 15–19 years – 27.0/25.6 cm for males and females, respectively; and for obesity were: For 10–14 years – 24.5/25.1, for 15–19 years – 28.5/28.0 cm for males and females, respectively. For overweight, among males, the age-specific cut-off ranged between 21.2 cm (10 years) and 29.8 (19 years), and for females ranged between 21.2 cm (10 years) and 26.7 cm (19 years). For obesity, it ranged between 22.4 cm (10 years) and 31.1 cm (18 years) for males, and 23.9 cm (10 years) to 26.9 cm (19 years) for females. For obesity, AUC ranged between 0.81 and 0.92, indicating good to excellent diagnostic accuracy. Conclusion: Age- and sex-specific MUAC cut-offs could be considered as a screening tool for identifying overweight and obese adolescents.

BackgroundLow birthweight small-for-gestational-age (SGA-LBW) (birthweight below the 10th percentile for gestational age; SGA-LBW) infants are at an increased risk of poor postnatal growth outcomes. Linear growth trajectories of SGA-LBW infants are less studied in South Asian settings including India.ObjectivesTo describe the linear growth trajectories of the SGA-LBW infants compared with appropriate-for-gestational-age LBW (AGA-LBW) infants during the first 6 months of life. In addition, we estimated catch-up growth (ΔLAZ > 0.67) in SGA-LBW infants and their performance against the WHO linear growth velocity cut-offs. Additionally, we studied factors associated with poor catch-up growth in SGA-LBW infants.MethodsThe data utilized came from an individually randomized controlled trial that included low birthweight (LBW) infants weighing 1,500–2,250 g at birth. A total of 8,360 LBW infants were included. For comparison between SGA-LBW and AGA-LBW infants, we presented unadjusted and adjusted estimates for mean differences (MDs) or risk ratios (RRs) for the outcomes of length, linear growth velocity, length for age z-score (LAZ) score, and stunting. We estimated the proportion of catch-up growth. Generalized linear models of the Poisson family with log links were used to identify factors associated with poor catch-up growth in SGA-LBW infants.ResultsLow birthweight small-for-gestational-age infants had a higher risk of stunting, lower attained length, and a lower LAZ score throughout the first 6 months of life compared with AGA-LBW infants, with differences being maximum at 28 days and minimum at 6 months of age. The linear growth velocity in SGA-LBW infants compared with AGA-LBW infants was significantly lower during the birth–28 day period [MD −0.19, 95% confidence interval (CI): −0.28 to −0.10] and higher during the 3- to 6-month period (MD 0.17, 95% CI: 0.06–0.28). Among the SGA-LBW infants, 55% showed catch-up growth for length at 6 months of age. Lower wealth quintiles, high birth order, home birth, male child, term delivery, non-exclusive breastfeeding, and pneumonia were associated with the higher risk of poor catch-up in linear growth among SGA-LBW infants.ConclusionSmall for gestational age (SGA) status at birth, independent of gestational age, is a determinant of poor postnatal linear growth. Promotion of institutional deliveries, exclusive breastfeeding, and prevention and early treatment of pneumonia may be helpful to improve linear growth in SGA-LBW infants during early infancy.Clinical Trial Registration[https://clinicaltrials.gov/], identifier [NCT02653534].

Quality of biotherapeutic products is of paramount importance for ensuring patient safety. Analytical tools that can facilitate rapid quality assessment of the therapeutic product at the point of care are very much in demand. In this article, we apply chemometrics based analysis of Raman spectra towards quantitative prediction of protein aggregation in lyophilized biotherapeutic products. Two commercially available therapeutic proteins, erythropoietin (EPO) and human growth hormone (HGH), have been used to demonstrate the applicability of the proposed approach. Thermally induced protein aggregation was monitored by size exclusion chromatography as well as Raman spectroscopy with a 785 nm wavelength laser. Partial least square (PLS) regression was used to analyse the Raman spectra and create a model for quantitative determination of aggregate. Satisfactory performance was observed with both EPO and HGH with R2 of 0.91 and 0.94, cross-validation correlation coefficient of 0.85 and 0.89, and Root Mean Square Error computed from cross calibration (RMSEcv) of 5.25 and 1.92, respectively. The developed approach can enable rapid and accurate assessment of aggregation in lyophilized samples of biotherapeutic products. The study also demonstrates novel use of Raman spectroscopy for protein quantification through a vial. • Chemometrics analysis of Raman spectra for quantification of aggregates in biotherapeutics • Demonstration of Raman spectroscopy for in situ protein aggregation determination • Advantages of Raman spectroscopy over conventional aggregate determination techniques such as SEC [ABSTRACT FROM AUTHOR]